Nurse navigators help patients wade through complex diagnoses

Nurse Navigator decorative image

Nurse navigator programs have a positive impact on patients with a complex cancer diagnosis, according to a first-of-its-kind, comprehensive study involving eight medical centers nationwide including MUSC Health.

“A cancer diagnosis leaves patients wondering where to turn and what happens next; at MUSC Health patients and their families don’t have to go it alone,” says Jennifer Wood, a nurse navigator with the Hollings Cancer Center.

“It was exciting to see that patients in the study felt that oncology navigation services enhanced their overall quality of care,” says Cindy Kramer, program director of Oncology Navigation and the Blood and Marrow Transplant Team Program at MUSC Health. “Participating in the study allowed us to showcase our program and challenged us to examine our standards and practices and look for ways to make the experience even better for our patients.”

MUSC Health was one of only two academic medical centers that participated in the study, conducted by the Academy of Oncology Nurse & Nurse Navigators, Chartis Oncology Solutions and the American Cancer Society.

The study validated the importance of oncology navigation programs for patients and their families. It showed that these types of programs provide better and quicker access to care, have a positive impact on patient outcomes and support coordination of care for patients through the entire cancer care continuum. Navigation programs also improve communication among patients, their families and their health care team, identify financial and community resources, ensure access to clinical trials and lead to enhanced patient satisfaction.

Key findings included:

Nurse-navigated patients progressed from diagnosis to treatment in 43 days – 11 days fewer than non-navigated patients.

The readmission rate for navigated patients was lower – 9.8 % for 30 days, 14.3 % for 60 days and 16.3% for 90 days.

“Patients also expressed a high rate of satisfaction with nurse navigator programs, and that’s particularly notable because it is linked to navigators’ assistance in overcoming barriers to care,” says Claudia Miller, a nurse navigator for the MUSC Health Lung and Thoracic Program. “Navigators encourage participation in treatment decisions, ask for treatment goals, and talk to patients about their needs and emotional concerns.”

Each site collected qualitative and quantitative data on 10 AONN evidence-based navigation metrics, including barriers to care, days from diagnosis to treatment and readmission rates for navigated patients. It examined outcomes, evaluated analytics, identified barriers/challenges to care, analyzed performance improvement processes and identified opportunities for future research.

The study identified key metrics that nurse navigator programs can adopt to measure their effectiveness and demonstrate success.

Study results include a toolkit that provides a framework and identifies benchmarks that existing and developing navigator programs can adopt to demonstrate their results.

MUSC’s navigator program has implemented a tool within the medical record that allows navigators to query data, meet specific benchmarks and identify areas for opportunity.

As the state’s only academic medical center and home to the National Cancer Institute-designated Hollings Cancer Center, MUSC treats some of the region’s most challenging and complex cases.

Every oncology patient is assigned a patient care coordinator, but the more complex cases – those requiring multidisciplinary, complex treatments – are assigned a specialty nurse navigator who advocates for them and helps them move seamlessly through their care continuum.

“Understandably, patients have questions about what to expect and what to do, and a nurse navigator is an integral member of the care team. From the moment of referral, a nurse navigator is with the patient every step of the way – even before the patient arrives at MUSC for treatment and care,” Wood says.

David Mahvi, M.D., oncology chief for the MUSC Health Integrated Center of Clinical Excellence, says the study highlights the Navigator Program as one more reason patients choose MUSC Health for their treatment and care. “Our patients are mothers, fathers, sons, daughters and grandparents. We understand that we’re not just treating a disease, but we’re caring for a loved one and, in many cases, a family. Our navigators help patients move through their treatment with dignity, confidence and assurance that we put their needs above all else.”